Fasciola hepatica causing acute pancreatitis complicated by biliary sepsis.

摘要

A 33-year-old recent immigrant from Uzbekistan with no medical history presented with a 2-day history of nausea, vomiting, fever, and right upper quadrant abdominal pain. On admission, he was febrile and had sinus tachycardia, conjunctival icterus, and right upper quadrant tenderness. Laboratory findings included a white blood cell count of 16,000/mm with 11% eosinophilia. Liver biochemical tests revealed increased aspartate aminotransferase (282 U/L [normal 1-37 U/L]), alanine aminotransferase (319 U/L [1-40 U/L]), total bilirubin (5.4 mg/dL [0-1.0 mg/dL]), direct bilirubin (3.8 mg/dL [0-0.3 mg/dL]), and alkaline phospha-tase (319 U/L [39-120 U/L]).